Westco Job Application

Westco Job Application
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Position applying for: *

Sales Delivery Warehouse Other
Westco location applying to work at: *
Are you physically able to perform the job? *

Yes No
When are you available to start? *
Are you 21 years of age or older? *

Yes No
Desired Salary
IF APPLYING FOR A DRIVING POSITION, WE WILL RUN A CURRENT MVR. SOME POSITIONS MAY REQUIRE A CDL.
Are you a citizen of the United States? *

Yes No
If no, are you authorized to work in the U.S.?

Yes No
Have you ever worked for this company? *

Yes No
If yes, what dates?
Have you ever been convicted of a felony? *

Yes No
If yes, please explain.
Education
High School
Did you graduate high school? *

Yes No
College/Vocation/Trade School
Did you graduate or earn a degree? *

Yes No
If yes, what degree did you earn?
References

Please list three professional and/or personal references
Reference # 1 First Name* Last Name*
Phone Number* Years Known*
Reference # 2 First Name* Last Name*
Phone Number* Years Known*
Reference # 3 First Name* Last Name*
Phone Number* Years Known*
Previous Employment

Please list your last three employers starting with the most recent
Previous Employment # 1
  Company Name*        Supervisor*         Phone Number*
  Dates Worked*      Job Title*   Job Responsibilities*
   Reason for Leaving*   Beginning and Ending Salary*
May we contact your previous supervisor for a reference? *

Yes No
Previous Employment # 2
Company Name*        Supervisor*         Phone Number*
Dates Worked*      Job Title*   Job Responsibilities*
   Reason for Leaving*   Beginning and Ending Salary*
May we contact your previous supervisor for a reference? *

Yes No
Previous Employment # 3
  Company Name*        Supervisor*         Phone Number*
   Dates Worked*      Job Title*   Job Responsibilities*
   Reason for Leaving*   Beginning and Ending Salary*
May we contact your previous supervisor for a reference? *

Yes No
Military Service

Leave blank if N/A
Military Service: Branch Dates of Service Rank at Discharge
Type of Discharge If other than hororable, please explain
Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. I authorize the investigation of all matters contained in the application, including background checks.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature *

Clear
Date *

Month Day Year
Date
Should be Empty:

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